Mount Vernon Nurse Sentenced For Home Health Care Scam That Defrauded Medicaid

NEW YORK, NY (March 13, 2007) – Attorney General Andrew M. Cuomo today announced that a licensed nurse was sentenced to prison for fraudulently billing Medicaid for home care to a severely disabled child that was never performed.

Marie Gilles, 56, of Mount Vernon, was sentenced to 1 to 3 years in prison for Grand Larceny in the Second Degree and ordered to pay $1,099,921 in restitution, including interest. The sentencing was ordered by Judge Richard A. Molea in Westchester County Supreme Court. Gilles pled guilty in November 2006 to stealing over $715,000 from the State.

From January 1995 to February 2005, Gilles submitted Medicaid claims falsely indicating she provided home health care services to a disabled child suffering from several conditions, including cerebral palsy. In fact, Gilles never actually performed the services.

The Attorney General’s investigation also found that the child’s mother, Maria Ortiz, was involved in the fraud, as she received kickbacks from Gilles. When confronted with the results of the investigation’s surveillance, Ortiz admitted to the scam and pled guilty to Grand Larceny in the Third Degree in December 2005. She was sentenced to 5 years’ probation and signed a confession of judgment for $51,000.

“Medicaid provides vital health care to many New York families,” said Attorney General Cuomo. “When the program is abused, it’s not only theft from the taxpayers – it’s an affront to those who legitimately depend on Medicaid. Scams that take advantage of vulnerable patients to steal hundreds of thousands of dollars are reprehensible.”

The case was prosecuted by Special Assistant Attorney General Gilbert Epstein of the Medicaid Fraud Control Unit’s Pearl River Regional Office. Special Investigator Dennis Johnston and Special Auditor/Investigator John Annunziata assisted in the investigation.